AYURVEDIC MANAGEMENT OF PALMO-PLANTER PSORIASIS: A CASE STUDY

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1 (ISSN ) REVIEW ARTICLE AYURVEDIC MANAGEMENT OF PALMO-PLANTER PSORIASIS: A CASE STUDY YOGESH JAKHOTIYA 1, VAISHALI KUCHEWAR 2 ABSTRACT Palmo-plantar psoriasis (PPP) is a type of Psoriasis limited to the area of the palms and soles. Though only small body surface area is affected, it is difficult to treat and seriously interferes with the patient s quality of life. It is found in 3-4% of all psoriasis cases. It is also found in isolation. There is no any direct correlation with any disease described in Ayurveda but somewhat it can be correlated with Vipadika which is one of the types of the Ksudrakushtha This is a case of palmo-planter psoriasis. He was taken treatment from different pathies. But due to frequent recurrence, he preferred Ayurvedic treatment. He was successfully managed with Ayurvedic treatment including internal medication & some external therapy for three months. Keywords: - Palmo-planter Psoriasis, Ksudrakushtha, Vipadika,Internal medication, External therapy 1 MD Scholar, 2 Professor and Head, Dept. of Kayachikitsa, Mahatma Gandhi Ayurveda College, Hospital & Research centre, Salod(H), Wardha, Maharashtra. Corresponding id: ynjakhotiya91@gmail.com Access this article online: Published by Atreya Ayurveda Publications under the license CC-by-NC. 59

2 INTRODUCTION Palmo-plantar psoriasis (PPP) is a type of Psoriasis limited to the area of the palms and soles. There are two common patterns: well-circumscribed, red, scaly, plaques similar to psoriasis elsewhere and Patchy or generalized thickening and scaling of the entire surface of palms and/or soles without redness (keratoderma) [1]. In most of the conducted studies, it is found in 3-4% of all psoriasis cases. It is also found in isolation [2].Though only small body surface area is affected, it is difficult to treat and seriously inte fe es with the patient s uality of life [3]. There is no any direct correlation with any disease described in Ayurveda, but somewhat it can be correlated with Vipadika which is one of the types of the Ksudrakushtha Jour. of Ayurveda & Holistic Medicine (skin disorder). It involves predominantly Vata-Kapha Dosha and characterized by Pani- Padasphutan (fissure in palms and soles) and Tivravedana (with severe pain) [4]. CASE REPORT Table no 1: Abhyantara chikitsa first one month A 19 years old male, visited to Kayachikitsa OPD of Mahatma Gandhi Ayurveda Hospital salod (H), Wardha with complaints of scaling on bilateral palms and soles with severe itching since 2 years. He took treatment of various pathies but was getting temporary relief so he came here for further treatment. On examination, the skin of both the soles was extremely thick, dry and fissured. The palms had 2 to 3 thick patches. His CBC and blood sugar was within normal range. Following treatment was given for three months. He had irregular bowel habits. His weight was 95 Kg. Sr.no Drug Dose Anupan 1. Arogyavardhini vati 500mg twice a day after meal 2. Gandhak rasayan 500mg twice a day after meal 3. Chopchini churna 3gm twice a day at 8 a.m p.m. 4. Haritaki churna 5gm at bed time Luke warm water 5. Panchatikta ghruta 10ml twice a day at 8 a.m p.m. Luke warm water 60

3 6. Mahamanjishthadi quath 20ml twice a day After meal Table no 2: Abhyantara chikitsa second month Sr.no Drug Dose Anupan 1. Panchatikta ghruta 10ml twice a day at 8 a.m p.m. Luke warm water 2. Mahamanjishthadi quath 20ml twice a day After meal Table no 3: Abhyantara chikitsa third month Sr.no Drug Dose Anupan 1. Yashad bhasma 250mg Rasamanikya 50mg twice a day Guduchi churna 3gm 2. Cap. Neem 250mg twice a day 3. Mahamanjishthadi quath 20ml twice a day After meal Table no 4: Bahya Chikitsa Sr no Drug Use Duration 1 Triphala quath Dhavan(local cleaning) Once a day 2 Karanja taila Local application Twice a day 3 Jatyadi ghruta Local application At night First 15 days First 1 month Last 2 month 61

4 4 Neem taila Local application In the morning Last 2 month Figure 1 Before treatment Figure 2 After treatment Figure 3 Before treatment Figure 4 After treatment Table no 5: Observation Sr. no Clinical features Before treatment After Treatment 1 Scaling of skin ++ No scales 2 Fissure(Bilateral lower limbs) +++ No fissure 3 Itching

5 4 Pain at fissure ++ No pain DISCUSSION: The treatment given in this patient was in accordance with the following properties of medicines. His clinical features indicated vitiation of Vata and Kapha (biological humors). In this patient Arogyavardhini vati and Gandhak Rasayan was given for 15 days as it is indicated in all types of Kushta roga (skin diseases) [5],[6]. Panchatikta ghruta was given for long period because it is described as best for all types of kushtha and it also pacifies vata which is the root cause of fissures and pain [7]. Mahamanjishtha qutha is given in kustha chikitsa in vrindamadhav as its is raktashodhak(blood purifier),kaphaghna(alleviates kapha) and kushtha nashak (alleviates skin ailments) [8].Chopchini churna was recommended for the reason that it is having blood purifying, immunomodulator and antimutagenic property [9]. Haritaki churna was given for koshtha shudhi (mild purgative) as well as strotoshuddhi (cleaning of body channels) so that the medicines should be reached up to the targeted cells. Yashad bhasma contains zinc which is known to promote healing [10]. Rasamanikya is a well-known drug, frequently used by Ayurvedic physicians for Vata-Kaphaja diseases like Shwasa (bronchial asthma), Kasa(cough) and Kushtha [11]. Triphala was used to made decoction for the cleaning of lesions because Triphalā is anti-inflammatory and astringent which is helpful to shed the scales of palms and soles. The Chikitsa Sthana of the Sushrut samhita recommends Triphala among medicines that are good for purification [12]. Neem taila, karanja taila and jatyadi ghruta were used for local application. Neem is kandughna (alleviate itching) [13],jati has kusthaghna(alleviate skin diseases), vranashodhak(wound cleaning property),vranaropak(wound healing property) [14] and karanj has jantughna(antimicrobial), kandughna, vrnaropan,vedanasthapan(pain reliever) [15]. Guduchi has been used in Ayurvedic preparations for the treatment of various ailments throughout the centuries. It is used as a rasayana(rejuvanator) to improve the immune system [16]. CONCLUSION: From the above case, it can be concluded that palmo-planter psoriasis can be successfully managed with Ayurvedic intervention. Further study can be conducted on large number of patients for verification of efficacy. REFERENCES: php 63

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